A Johns Hopkins University analysis of health insurance records has found that states legalizing online sports betting also saw increases in treatment for depression and anxiety among working-age adults with employer-sponsored coverage.
The results, published Oct. 14 in JAMA Psychiatry, do not establish that sports-betting legalization caused the increase. But they add new evidence to a policy debate that has often centered on tax revenue, consumer choice and sports integrity rather than behavioral-health demand.
What the study found
Researchers examined insurance records from 2016 through 2023 and compared states that legalized online sports betting with states that did not. Following legalization, prescriptions for antidepressants and anti-anxiety medications rose by roughly 5% among adults aged 18 to 64 with employer-sponsored health insurance, according to the report.
Outpatient diagnoses of depression and anxiety increased by about 5% to 7%. The findings indicate a change in use of care and medication recorded in insurance data; they do not by themselves identify why each individual sought treatment.
Online sports betting is now legal in 31 states and Washington, D.C., expanding access to betting through phones and other connected devices. The study’s state-level comparison offers a way to examine whether broader legal availability coincided with changes in behavioral-health care use.
Association is not proof of cause
The researchers’ results are observational. That distinction is important: the analysis reports an association after legalization, not proof that legalized betting directly produced every new diagnosis or prescription.
Depression and anxiety are influenced by many factors, and treatment data can shift for reasons including access to care, insurance practices, economic conditions and changes in screening. Still, the pattern was sufficiently notable for the authors to warn that legalization may place additional strain on mental-health systems.
For policymakers, the finding shifts attention from gambling losses alone to the services that may be needed when gambling-related problems spill into daily life.
Why gambling harms extend beyond money
Danielle Piatkowsky, a licensed social worker at Northwell Zucker Hillside Hospital who was not involved in the study, said problem gambling can affect mental health through more than financial stress.
Its effects may reach family and social relationships, as well as work or school performance. That broader impact is why problem gambling is increasingly framed as a public-health issue rather than solely a matter of personal finance or entertainment.
The study cannot determine how many of the observed treatment changes involved gambling problems directly. But it provides a population-level signal that deserves scrutiny as online betting becomes more available.
What comes next
The findings point to a need for continued research into who is most affected by sports-betting legalization, what forms of support are most effective and how states can monitor behavioral-health effects alongside economic outcomes.
They also underscore the value of making help accessible for people who feel their gambling is becoming difficult to control. Treatment and professional support can address both mental-health symptoms and the effects gambling can have on relationships, employment and finances.
As more jurisdictions weigh new betting laws, the Johns Hopkins analysis supplies a measurable concern: legal access may be accompanied by increased demand for depression and anxiety care. Whether that relationship reflects a direct effect of betting, related stresses or a combination of factors will require further study.
Study details
- Researchers reviewed health insurance records from 2016 to 2023.
- The analysis covered adults aged 18 to 64 with employer-sponsored insurance.
- Medication use for depression and anxiety rose by roughly 5% after legalization in the study comparison.
- Outpatient depression and anxiety diagnoses increased by about 5% to 7%.
- The research was published in JAMA Psychiatry on Oct. 14, 2026.
This article is based on reporting by Medical Xpress. Read the original article.
Originally published on medicalxpress.com
